Arthroscopy to repair a proximal ruptured biceps tendon is performed in a hospital operating room under general anesthesia. The surgery is referred to as Arthroscopic Biceps Tenodesis. The surgeon will make several small incisions, about ¼ inch each, to the shoulder area.
These incisions result in very small scars, which in many cases are unnoticeable. In one portal, the arthroscope is inserted to view the shoulder joint. Along with the arthroscope, a sterile solution is pumped into the joint which expands the shoulder joint, giving the surgeon a clear view and room to work.
The other portal is used for the insertion of surgical instruments. A surgical instrument is used to probe various parts within the joint to determine the extent of the problem. Any bone spurs present that may have contributed to the rupture will be shaved with an instrument called a burr.
The surgeon will locate the biceps tendon and debride (remove) any frayed edges that occurred from the rupture. The biceps tendon will then be attached to the humerus bone, the upper arm bone, as opposed to its original location on the labrum within the shoulder. The tendon is secured to the humerus with a special screw.
After treating the problem, the portals (incisions) are closed by suturing or by tape. Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the shoulder with long incisions (open technique).
Post Operative Care
You will wake up in the recovery room and then be transferred back to the ward.
- A bandage will be around the operated shoulder and the shoulder placed in a soft sling. Once you are recovered your IV will be removed and you will be shown a number of exercises to do. You will be encouraged to move your fingers and wrist often.
- Your surgeon will see you prior to discharge and explain the findings of the operation and what was done during surgery.
- Pain medication will be provided and should be taken as directed.
- You can remove the bandage in 24-72 hours to shower, depending on your surgeon’s preference, and place dressings provided by your surgeon over the area.
- It is NORMAL for the shoulder to swell after the surgery. Placing ice-packs on the shoulder will help to reduce swelling. (Ice packs on for 20 min 3-4 times a day until swelling has reduced).
- Physical therapy will be ordered to restore normal upper arm function and strength. It is imperative that you follow your therapist’s instructions to prevent complications.
- You will be able to drive when you are off pain medications and no longer in a sling, usually about 3 weeks.
- You should make an appointment with your surgeon 7-10 days after surgery to monitor your progress.
- Eating a healthy diet and not smoking will promote healing.
Risks and Complications
As with any surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place.
Complications can be medical (general) or specific to Biceps Tendon Rupture surgery. Medical complications include those of the anesthetic and your general well being. Almost any medical condition can occur so this list is not complete.
- Allergic reactions to medications
- Blood loss requiring transfusion with its low risk of disease transmission
- Heart attacks, strokes, kidney failure, pneumonia, bladder infections
- Complications from nerve blocks such as infection or nerve damage
- Serious medical problems can lead to ongoing health concerns, prolonged hospitalization, or rarely death.